Spinal Cord Stimulation Implantation for Pain Relief (Trial Phase)

How Long Does the Spinal cord stimulation Trial Last?

A spinal cord stimulator trial period is at least 5 to 7 days. This gives you time to test the device and evaluate its effectiveness managing your pain at rest and during activity. While SCS may not completely eliminate your pain, a 50% reduction in pain is considered a successful trial. A growing number of physicians now focus on improved quality of life, not only on the percentage of pain reduction.

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What does recovery look like after the procedure?

Approximately 10 days after surgery you will come to the office to have the incision checked. Bring your device remote and product box to your follow-up appointment with the surgeon. Programming of the pulse generator can be adjusted at this time if needed. It is important to work with your doctor to adjust your medications and refine the programming of the stimulator. Your pain specialist and device representative will work with you to fine-tune adjustments to the SCS.

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Why is this procedure called a trial?

Before a patient can receive a spinal cord stimulator implant--a permanent implant in the spinal canal--he or she must undergo a spinal cord stimulator trial. The trial phase is extremely important, as it will allow your pain management provider to determine how effective spinal cord stimulation is in relieving your pain.   During the trial phase, the epidural space--the outermost area of the spinal canal--is accessed using x-ray guidance and an epidural needle. Once proper placement of the needle has been confirmed, your pain specialist will insert a small electrode through the needle and confirm proper placement in the epidural space. These electrodes are connected to a spinal cord stimulator device that, when activated, sends tiny electrical pulses to the epidural space. After one electrode is successfully placed, the process is repeated to place a second electrode. Placement of two electrodes is typical during the trial phase.  After proper placement of the electrodes, a member of the device’s team will activate the spinal cord stimulator and ask you to describe the sensations you experience as he or she adjusts the device’s settings. A successful trial will gradually replace pain sensations with a pleasant tingling feeling, a process which typically takes only 10 minutes.   After the initial test of the electrodes, your pain specialist will remove the epidural needle and secure the electrodes to your back with tape and a small number of stitches. Once this is complete, you will leave the clinic and begin a 5-day trial of the device. During the trial, you should continue all daily activities normally. You should also continue to take any prescribed daily pain medications. During this time, pay close attention to your pain levels and how your activity level is affected due to your pain.   At the end of the five day trial period, you will return to the pain clinic to have the electrodes removed. You will also talk to your doctor about the effectiveness of the trial in reducing your daily pain.   If you experienced at least a fifty percent reduction in pain and were able to complete daily activities more easily, you’re likely a good candidate for a spinal cord stimulator implant.

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What happens next if my trial procedure is successful?

If a patient has undergone a successful spinal cord stimulator trial, he or she may elect to receive a permanent implanted device.   Permanent implantation of a spinal cord stimulator is a surgical procedure that is performed under general anesthesia in an operating room. The permanent implantation can be done via laminotomy, performed by an outside surgeon, or via percutaneous implant, performed by a pain specialist.    It’s important to talk with your doctor about the risks, benefits and potential complications of permanent implantation via laminotomy versus percutaneous implantation.